The purpose of the study was to explore and describe the lived experiences of neophyte professional nurses working in ICU during their first year post graduation with the aim to discover strategies to support the nurse in critical care unit. An explorative, descriptive, interpretative qualitative design was conducted to uncover the nurse’s experiences. A purposive sampling was used which is based on belief that the researcher’s knowledge about the population can be used to hand pick sample elements. Data was collected through in-depth unstructured interviews and written narratives. Collaizi’s method of data analysis was used. The study findings revealed that neophyte professional nurses experienced difficulties and challenges in adjusting to the unit because of lack of mentors emanating from the shortage of staff. Nurses experienced mixed feelings regarding the relationship with colleagues in terms of support received. / Health Studies / M.A. (Health Studies)

Bakgrund: De intrahospitala transporterna av kritiskt sjuka patienter ökar på grund av en alltmer avancerad intensivsjukvård. Transporterna är ofta associerade med komplikationsrisker och kan därmed även påverka patientsäkerheten, trots detta saknas det idag studier om intensivvårds-sjuksköterskans erfarenhet ur ett patientsäkerhetsperspektiv. Syfte: Syftet med studien var att belysa intensivvårdssjuksköterskans erfarenhet av en patientsäker intrahospital transport för kritiskt sjuka patienter som vårdas på en intensivvårdsavdelning. Metod: Studien utfördes genom semi-strukturerade fokusgruppsintervjuer med kvalitativ induktiv design. Under tre intervjuer samlades data in med hjälp av totalt tretton intensivvårds-sjuksköterskor. Insamlat material analyserades med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier; förberedelsens betydelse för patientsäker intrahospital transport, kommunikationens betydelse för patientsäker intrahospital transport samt yttre faktorer som kan påverka patientsäkerheten. Slutsats: För att förbättra patientsäkerheten rekommenderar författarna att arbeta med och uppdatera checklistor, förespråka god kommunikation samt använda sig av teamövningar. Den nya kunskapen skulle ur ett patient- och samhällsperspektiv kunna ge en ökad insikt och förståelse inför det preventiva arbetet med att motverka vårdskador samt minska onödigt lidande hos patienterna samt även kunna vara användbart ur ett utbildnings-perspektiv. Vidare forskning avseende samarbetets betydelse vid intrahospitala transporter samt att få ökad kunskap om olika förbättringsområden avseende den tekniska utrustningen, vore också önskvärt. / Background: The intrahospital transport of critically ill patients is increasing due to gradually advanced intensive care. Transports are often associated with complication risks and can thus also affect patient safety. Despite this, studies on the experience of the intensive care nurse from a patient safety perspective are lacking. Aim: The aim of the study was to highlight the intensive care nurse's experience of a patient-safe intrahospital transport for critically ill patients who are cared for in an intensive care unit. Method: The study was carried out through semi-structured focus group interviews with qualitative inductive design. During three interviews, data were collected using a total of thirteen intensive care nurses. The collected material was analyzed with a qualitative content analysis. Results: The analysis resulted in three categories; the importance of the preparation for patient-safe intrahospital transport, the importance of communication for patient-safe intrahospital transport and external factors that can affect patient safety. Conclusions: In order to improve patient safety, the authors recommend working with and updating checklists, advocating good communication and using team exercises. The new knowledge could, from a patient and societal perspective, provide an increased insight and understanding of the preventive work to counteract health injuries and reduce unnecessary suffering in patients and also be useful from an educational perspective. Further research on the importance of cooperation in intrahospital transport and to gain more knowledge about different areas of improvement regarding the technical equipment would also be desirable.

Intensive care units in South Africa have been faced with various challenges which in turn affect the working condition of critical care nurses, thus leading to poor productivity. Nurses in the work environment blame this poor work quality of nursing to the way critical care nurses are trained and assessed in nursing schools. There is general concern that graduate nursing students lack the knowledge and skills necessary to equip them to work in intensive units. Objectives: To measure the perceptions of critical care nursing students as well qualified critical care nurses on the use of OSCE as a valid and reliable tool to assess clinical competence in critical care nursing students. Methods: A quantitative approach and descriptive survey was administered to critical care nursing students and qualified critical care nurses who had participated in OSCE examination. The intensive care departments of two provincial (states) hospitals and (provincial) nursing college that trained critical care nurses were used. Results: The findings revealed that OSCE was still overwhelmingly accepted as a relevant tool for assessing clinical competencies in Critical Care courses by both students and staff. It was also clear that the students did not believe that all the competencies required in the ICU environment can be assessed using the OSCE method. Discussion: Critical care nursing educators are facing a challenge to develop more comprehensive method for assessing clinical skills in critical care students nurses since OSCE x examination cannot assess all the skills that are necessary in intensive care environment. In order for effective learning to take place during assessment, it is extremely important for nurse educators to give formative feedback in OSCE. / M.N. University of KwaZulu-Natal, Durban 2012.

No description available.

Abstract In the Czech Republic there is no doubt about the tendency of gradual increase in median life expectancy, which is significantly affected by the fact that mortality from cardiovascular diseases, especially from acute coronary syndromes, has been decreasing. Besides the provable effect of a healthy lifestyle, diet and, by all means, a quality and effective pharmacotherapy, a significant development in the field of interventional cardiology contributes to this accomplishment. The number of coronographies, coronary angioplasties and implanted stents have multiplied, and today the invasive coronarographic diagnostics and percutaneous myocardial revascularization belong to the the most common diagnostic and therapeutic methods in treatment of acute forms of ischemic heart diseases. An obvious prerequisite for such a rapid development in the field of intervention coronary angiography was the establishment of a sufficiently dense network of catheter laboratories and specialized facilities, which provide a highly professional and intensive care for patients. This thesis is focused on three basic objectives: ? To survey and characterize differences in nursing care concerning various complications in patients after SKG / PCI ? To survey bio / psycho / social impacts of complications after SKG / PCI on a patient ? To identify and summarize personal and material prerequisites and requirements to ensure quality nursing care for these complicated conditions The research was conducted by using a qualitative methodology. The methods used were observation, non-standardized interviews and medical and nursing records analyses. The research survey samples on which the investigation was focused were patients with the acute coronary syndrome hospitalized in the coronary care unit in the Cardio Center in České Budějovice, their family members and also the nursing staff providing the comprehensive nursing care. The outcomes of this survey were eleven descriptive case reports characterizing the occurrence of the most frequent complications in patients with ACS after SKG / PCI. To ensure clarity, each case study is complemented by a thought map with an account of the most important nursing interventions in the management of specific acute conditions. The paper also contains a framework analysis of bio / psycho / social impacts of complicated situations on patients. It is interesting to compare this matter from the perspective of nurses and patients, which is seen in correlation graphs. The section describing the organizational and personnel provision is introduced with the characteristics of the medical process and it also contains the list of medical personnel with their qualifications and the length of experience in the Coronary care unit in České Budějovice. Summarization of the instrumental medical equipment is also based on the analysis of previous cases and is accompanied by photographs of the equipment typical and indispensable for the care of patients in the Coronary care unit, which primarily has an informative and complementary character to get an integrated view of the Coronary care unit running and the nursing staff work.

Bakgrund: Organdonation kan rädda människors liv när all annan möjlig behandling redan testats. Behovet av organ i Sverige överskrider idag tillgången, vilket resulterar i att människor avlider i väntan på ett organ. Förutom att möjliggöra en människas överlevnad är transplantation mer kostnadseffektivt än kontinuerlig behandling. I nuläget finns inga nationella riktlinjer i Sverige för utbildning inom organdonation för intensivvårdssjuksköterskor. Forskning har visat att intensivvårdssjuksköterskans arbete är av stor vikt för donationsprocessen. Syfte: Syftet med studien är att belysa behovet av utbildning hos intensivvårdssjuksköterskor som vårdar potentiella avlidna donatorer. Metod: Studien har utförts genom en litteraturstudie med systematisk datainsamling. Integrativ metod med en kvalitativ innehållsanalys har använts då artiklar med både kvalitativ och kvantitativ ansats analyserats för att besvara syftet för studien. Resultat: En stor del intensivvårdssjuksköterskor upplevde sig vara obekväma med att vårda organdonatorer. Vårdandet av en donator kan medföra att mycket känslor uppstår hos intensivvårdssjuksköterskan och upplevdes som mentalt påfrestande. Utbildning inom organdonation kan hjälpa intensivvårdssjuksköterskan att hantera dessa känslor. Utbildning kan även leda till att fler potentiella donatorer identifieras. Utbildning behöver ges regelbundet och intensivvårdssjuksköterskan behöver specifikt utbildning om donationsprocessen, bemötande och kommunikation av de närstående samt skillnader i hjärt- och hjärndöda patienter. Slutsats: Intensivvårdssjuksköterskan behöver få en djupare förståelse av vården kring organdonation och få en ökad kunskap och utbildning för att stärka sin professionella roll. Utbildning kan även förbättra donationsprocessen och möjliggöra för fler donatorer. Vidare forskning inom området anses behövas för att utveckla vården kring donatorer och närstående. / Background: Organ donation can save lives when all other treatment options have been exhausted. Today, the demand for organs in Sweden exceeds supply, resulting in people dying in wait for an available organ for transplantation. In addition to saving a person’s life, transplantations are more cost-effective than continuous treatment. Currently, there are no national guidelines for the provision of training in the area of organ donations for intensive care nurses. Research has shown that the efforts of intensive care nurses play a major role in the donation process. Aim: The aim of this study is to shed light on the need for training of intensive care nurses caring for potential deceased donors. Methodology: The study was conducted through a literature review with systematic data collection. An integrative method with qualitative content analysis was employed, as articles with both qualitative and quantitative approaches were analysed to shed light on the aim of the study. Findings: A large proportion of intensive care nurses felt uncomfortable caring for organ donors. Caring for a donor can be a very emotional and mentally trying experience for intensive care nurses. Organ donation training can help intensive care nurses cope with these feelings. Training can also result in the identification of more potential donors. Regular training is necessary, and intensive care nurses require specific training on the donation process, treatment and communication with next of kin as well as differences between donation after cardiac death patients and donation after brain death patients. Conclusion: The intensive care nurses needs to gain a deeper understanding of the care surrounding organ donation. To increase the professional role of the nurse there is a need to strengthen the knowledge and education. The donation process could be improved by education, which can lead to more organ donations. Further research within this area of expertise needs to be done to be able to develop the care for the donors and their families.

The purpose of the study was to explore and describe the lived experiences of neophyte professional nurses working in ICU during their first year post graduation with the aim to discover strategies to support the nurse in critical care unit. An explorative, descriptive, interpretative qualitative design was conducted to uncover the nurse’s experiences. A purposive sampling was used which is based on belief that the researcher’s knowledge about the population can be used to hand pick sample elements. Data was collected through in-depth unstructured interviews and written narratives. Collaizi’s method of data analysis was used. The study findings revealed that neophyte professional nurses experienced difficulties and challenges in adjusting to the unit because of lack of mentors emanating from the shortage of staff. Nurses experienced mixed feelings regarding the relationship with colleagues in terms of support received. / Health Studies / M.A. (Health Studies)

Bakgrund: Pandemin orsakad av Covid-19 har tvingat intensivvården till stora omställningar. Som del av restriktioner för att reducera risk för smittspridning måste skyddsutrustning användas vid patientkontakt med smittad patient. Användandet av skyddsutrustning har introducerat tankar på hur den vårdande relationen mellan patient och intensivvårdssjuksköterska påverkats.  Syfte: Syftet med studien var att belysa intensivvårdssjuksköterskans upplevelse av hur arbetet i skyddsutrustning under pågående pandemi påverkat den vårdande relationen med patienten. Metod: Semistrukturerade intervjuer genomfördes med sex intensivvårdssjuksköterskor. Intervjuerna låg vidare till grund för analys enligt tolkande fenomenologisk analys (IPA).  Resultat: Fyra överordnade teman framträdde ur analysen. I temat fokus på kommunikation framkom olika sätt skyddsutrustningen påverkat kommunikationen. Upplevelsen av avskärmning framkom i temat fokus på distans där närhet uttrycktes som avgörande för en vårdande relation. I temat fokus på lidande beskrevs hur skyddsutrustningen inverkat på lindrande beröring men också att den kan orsaka lidande. Känslor av otillräcklighet i den vårdande relation och maktlöshet inför att inte förmå förändra eller påverka framkom i temat fokus på känslor.  Slutsats: Skyddsutrustningen påverkar den vårdande relationen. Skyddsutrustningen reducerar möjligheten till etablering av vårdande relation vilket riskerar minska patientens möjlighet till delaktighet. Behov föreligger av ytterligare forskning om påverkan med fokus på prevention. Ett organisatoriskt medvetande om skyddsutrustningen inverkan på den vårdande relationen kan ligga till grund för interventioner ämnade att reducera dess negativa påverkan. / Background: The pandemic caused by COVID-19 has forced the intensive care to make several adjustments. As part of restrictions to prevent spread of infection personal protective equipment (PPE) has to be used when in contact with infected patients. The use of PPE has introduced questions of its impact on the caring relationship between the patient and intensive care nurse.  Aim: The aim with this study was to illustrate the intensive care nurses experience of how working in PPE during the pandemic has affected the caring relationship with the patient.  Method: Semi- structured interviews was conducted with six intensive care nurses. The interviews served as data for an interpretative phenomenological analysis (IPA).  Results: Four superior themes emerged from the analysis. In the theme focus on communication emerged different way of which the PPE has affected communication. The experience of being shielded emerged in the theme focus on distance where closeness was expressed as essential. In the theme focus on suffering was the PPE´s impact on touch described and also its potential cause of suffering. Emotions of inadequacy in regards to the caring relationship and powerlessness in regards of not being able to change or affect emerged in the theme focus on emotions.  Conclusion: The caring relationship has been affected by the use of PPE. PPE reduces the possibility of establishing a caring relationship which endangers the patient’s active participation. There is need for further research about affect with focus on prevention. An organizational awareness regarding PPE´s effect on the caring relationship could lay the foundation for interventions supposed to reduce its negative impact.

Bakgrund: En av de vanligaste orsakerna till avvikelse inom vården är brister i den muntliga kommunikationen vid överrapportering av patient mellan enheter. Dagligen sker överrapporteringar av patienter mellan specialistsjuksköterskor inom anestesi- och intensivvård. Bristande överrapportering kan bidra till sämre vårdkvalité och ökad risk för komplikationer för patienterna. Syfte: Att beskriva specialistsjuksköterskor inom anestesi- och intensivvårds erfarenheter av överrapportering inom vården. Metod: En kvalitativ enkätundersökning med demografiska och öppna frågor med induktiv ansats där 17 enkätsvar har analyserats. Resultat: Efter analys framkom två kategorier med subkategorier. Den ena kategorin var Faktorer som främjar överrapportering med subkategorierna Att viktig information förmedlas och Att ha bra struktur vid överrapportering. Andra kategorin var Faktorer som stör överrapportering med subkategorierna Yttre faktorer påverkar överrapportering och När överrapportering brister. Slutsats: Kommunikationsverktyg och checklistor behövs för att minska risken att viktig information uteblir vid överrapportering. Genom att ha ett gemensamt förhållningssätt av vilken information och hur informationen ska kommuniceras kan följsamheten i överrapportering öka i det dagliga arbetet. / Background: One of the most common causes for deviation in healthcare is deficiency of the verbal communication in handovers of a patient between units. The handovers of patients occur on a daily basis between anesthetist nurses and intensive care nurses. Deficiency in handovers can contribute to decreased quality of care and increased risk of complication for the patients. Aim: To describe the experience of handover from anesthesia and intensive care nurses in healthcare.  Method: Qualitative survey with demographic and open questions with an inductive approach where 17 surveys were analyzed. Results: The analysis resulted in two categories emerged with subcategories. One category was Factors that improves handover with the subcategories That important information is conveyed and To have good structure in handover. The other category was Factors that disturb handover with the subcategories External factors affect handover and When handover deficient. Conclusion: This master thesis has demonstrated experiences from specialist nurses in anesthesia and intensive care with various factors that can promote and disrupt handover in healthcare. Communication tools could be seen as a common thread through the results where checklists reduced the risk for lack of important information. Through a common approach of what information and how the information is to be communicated, compliance of handover can increase in the daily work.

Bakgrund: Antalet äldre personer med multisjuklighet ökar i samhället och allt fler vårdas i hemmet. Att utifrån detta tillämpa personcentrerad vård skapar nya utmaningar. Lagen om samverkan vid utskrivning från slutenvård (SVU) och upprättande av samordnad individuell plan (SIP) innan utskrivning är interventioner som kan främja personcentrerad och integrerad vård i hemmet. Samordning genom SIP sker många gånger mellan hälso- och sjukvård och socialtjänst. Distriktssköterskan utses ofta till fast vårdkontakt för patienten och därmed ansvarig för SIP.  Motiv: Hälsocentral och kommunal hemsjukvård är viktiga samarbetspartner för integrerad vård på primärvårdsnivå och distriktssköterskan är ofta ansvarig för SIP. För att identifiera vad som hindrade och främjade tillämpning av SIP undersöktes distriktssköterskans erfarenheter av det. Resultat av studien kan öka förståelsen av SIP som arbetssätt. Syfte: Syftet med denna studie var att belysa distriktssköterskors erfarenheter av att arbeta med SIP på primärvårdsnivå. Metod: Under år 2021 genomfördes individuella semistrukturerade intervjuer med distriktssköterskor (n=8). Kvalitativ innehållsanalys användes för att analysera data. Resultat: Utifrån intervjuerna framkom varierande erfarenheter av att arbeta med SIP. Arbetssättet upplevdes främja personcentrerad och patientsäker vård men det framkom även svårigheter att använda det. Erfarenheterna beskrevs som fyra kategorier: förutsättningar för ökad delaktighet, behov av ansvarsförtydligande, säkerhet för alla inblandade, och otillräckligt inarbetat arbetssätt.  Konklusion: Sammanfattningsvis visade studien att SIP kan ha betydelse för tillämpning av patientsäker och personcentrerad vård. SIP kan genom hembesök och digitala möten förbättra patientens delaktighet samt bidra till en sammanhållen, integrerad vård i hemmet. Bättre struktur för att tillämpa arbetssättet efterfrågades, utan att riskera att SIP blir en standardiserad arbetsrutin. / Background: The number of people with multimorbidity is increasing, hence healthcare is often provided at their home. Furthermore, striving to apply person-centred care creates new challenges. Interventions to promote person-centered and integrated care are based on the law for coordination of care at discharge from hospital and demands establishment of a coordinated individual plan (CIP) before discharge. Coordinating care through CIP often occurs between healthcare and social services. The district nurse is often appointed to be the permanent contact concerning care for the patient and thus responsible for CIP.  Motive: Primary care centres and municipal units for home care are important partners in integrated care at primary care level and district nurses are often responsible for CIP. To identify the barriers and facilitators for the using of CIP, we explored the district nurses' experiences about it. The results of the study may contribute to better understanding of CIP as a working method. Aim: The purpose of this study was to highlight the district nurses' experiences of working with the CIP at primary care level. Methods: In 2021, individual semi-structured interviews with district nurses were conducted (n=8). Qualitative content analysis was used to analyse the data. Result: From the interviews, various experiences emerged regarding the experiences of using CIP. Using CIP was experienced as facilitating person-centred care and patient safety, but several obstacle and difficulties to adopt it were identified. The experience resulted in four categories: prerequisites for increased participation, need for accountability, safety for all involved, and insufficiently established working method.  Conclusion: In summary, the study showed that CIP is important for the application of patient-safe and person-centered care. Through home visits and digital meetings, CIP can improve patient participation and contribute to a cohesive, integrated care at home. Better structure for using the CIP as working method was requested, in order to avoid that CIP  becomes only a standardized work routine.